TY - JOUR
T1 - The Role of Systemic Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction
AU - Weerts, Jerremy
AU - Mourmans, Sanne G. J.
AU - Aizpurua, Arantxa Barandiarán
AU - Schroen, Blanche L. M.
AU - Knackstedt, Christian
AU - Eringa, Etto
AU - Houben, Alfons J. H. M.
AU - van Empel, Vanessa P. M.
N1 - Funding Information: Funding: This work was funded by the Dutch Heart Foundation [CVON2017-21, SHE PREDICTS HF] (V.v.P.M.E., B.L.M.S., A.J.H.M.H.). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Heart failure with preserved ejection fraction (HFpEF) is a condition with increasing incidence, leading to a health care problem of epidemic proportions for which no curative treatments exist. Consequently, an urge exists to better understand the pathophysiology of HFpEF. Accumulating evidence suggests a key pathophysiological role for coronary microvascular dysfunction (MVD), with an underlying mechanism of low-grade pro-inflammatory state caused by systemic comorbidities. The systemic entity of comorbidities and inflammation in HFpEF imply that patients develop HFpEF due to systemic mechanisms causing coronary MVD, or systemic MVD. The absence or presence of peripheral MVD in HFpEF would reflect HFpEF being predominantly a cardiac or a systemic disease. Here, we will review the current state of the art of cardiac and systemic microvascular dysfunction in HFpEF (Graphical Abstract), resulting in future perspectives on new diagnostic modalities and therapeutic strategies.
AB - Heart failure with preserved ejection fraction (HFpEF) is a condition with increasing incidence, leading to a health care problem of epidemic proportions for which no curative treatments exist. Consequently, an urge exists to better understand the pathophysiology of HFpEF. Accumulating evidence suggests a key pathophysiological role for coronary microvascular dysfunction (MVD), with an underlying mechanism of low-grade pro-inflammatory state caused by systemic comorbidities. The systemic entity of comorbidities and inflammation in HFpEF imply that patients develop HFpEF due to systemic mechanisms causing coronary MVD, or systemic MVD. The absence or presence of peripheral MVD in HFpEF would reflect HFpEF being predominantly a cardiac or a systemic disease. Here, we will review the current state of the art of cardiac and systemic microvascular dysfunction in HFpEF (Graphical Abstract), resulting in future perspectives on new diagnostic modalities and therapeutic strategies.
KW - Endothelial dysfunction
KW - Heart failure with preserved ejection fraction
KW - Microcirculation
KW - Microvascular dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85124329991&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/biom12020278
DO - https://doi.org/10.3390/biom12020278
M3 - Review article
C2 - 35204779
SN - 2218-273X
VL - 12
JO - BIOMOLECULES
JF - BIOMOLECULES
IS - 2
M1 - 278
ER -